寒冷条件下伤病员后送标准研究  

Standard study on the evacuation of casualties in cold conditions

作　　者：韩劲松 王婷婷 田竞 金海 张贺 颜晗 陆辉 HAN Jinsong;WANG Tingting;TIAN Jing;JIN Hai;ZHANG He;YAN Han;LU HUI(Department of Cardiac Surgery,General Hospital of Northern Theater Command,Shenyang 110840,China;Department of Medical Information,General Hospital of Northern Theater Command;Department of Orthopaedics,General Hospital of Northern Theater Command;Department of Neurosurgery,General Hospital of Northern Theater Command;Department of Planning Section of Medical Service,General Hospital of Northern Theater Command;General Hospital of Northern Theater Command)

机构地区：[1]北部战区总医院心血管外科,辽宁沈阳110840 [2]北部战区总医院医学情报科 [3]北部战区总医院骨科 [4]北部战区总医院神经外科 [5]北部战区总医院卫勤部计划科 [6]北部战区总医院

出　　处：《西北国防医学杂志》2020年第4期199-206,共8页Medical Journal of National Defending Forces in Northwest China

基　　金：辽宁省自然科学基金计划重点项目(20170540977);全军军事理论科研计划项目(19LBJ1003B,19LBJ1009B);军队后勤科研项目(CLB18L049,CLB18J054);“十三五”时期全军军事理论科研计划项目。

摘　　要：目的:探讨寒冷条件下伤病员医疗后送优先标准及恰当的后送平台,为提高后送效率、降低病死率提供参考依据。方法:结合美国战术作战伤员救护(tactical combat casualty care,TCCC)指南及相关文献对寒冷条件下伤病员医疗后送相关标准及后送平台进行研究。结果:在寒冷条件下伤病员后送过程为提高后送效率,降低病死率,可采取措施:①严格掌握寒冷条件下伤病员后送分类标准,将伤病员分为A-紧急、B-优先、C-常规3类,按优先级别有序后送危重伤病员;②在火线暴露地段使用伤员后送(casualty evacuation,CASEVAC)平台,在相对安全地域尽量使用空中医疗后送(medical evacuation,MEDEVAC)平台进行伤病员医疗后送;③加强后送途中体温监测,对重度低温伤员及时使用体外膜肺氧合(extracorporeal membrane oxygenation,ECMO)主动复温。结论:在寒区战场恶劣条件下根据相应后送标准有序后送伤病员可有效提高后送效率,降低后送阶段伤病员病死率。Objective:To discuss priority standard and appropriate platform for evacuation of the wounded in cold area,improving the efficiency and reducing the mortality rate.Methods:Combined with the US tactical combat casualty care(TCCC)guidelines and relevant literature,this paper studies the relevant standards for medical evacuation of casualty in cold conditions.Results:In order to improve the efficiency of casualty medical evacuation and reduce the mortality rate,we should make the following three points.①Strictly master the classification standards for the evacuation of the casualty under cold conditions,classify the casualties into three categories:A-emergency,B-priority and C-routine,and then send the seriously injured patients in an orderly manner according to the priority level.②When in the line of fire exposure phase,we should use the casualty evacuation(CASEVAC)platform,and in a relatively safe area we should try to use the air medical evacuation(MEDEVAC)platform for casualty medical evacuation.③The body temperature monitoring should be strengthened during the evacuation of casualty,and the patients with severe hypothermia should be actively rewarmed by extracorporeal membrane oxygenation(ECMO)in time.Conclusion:According to the corresponding standards the orderly evacuation of casualty can effectively improve the efficiency of evacuation and reduce the death rate of casualties in the evacuation stage.

关 键 词：伤员后送 寒冷环境 标准 

分 类 号：R82[医药卫生—临床医学]